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“I can see fine. Why do I need my eyes tested?”

Are routine eye examinations really necessary? The author asks whether frequent appointments in low-risk patients with normal results are actually cost-effective. It’s recommended that most people should get their eyes tested every two years.” [1] This message is widely publicised...

Developing community eye care: the evolution of Wales’ eye care services

In the third in our series about community eye care in the home nations, David O’Sullivan explains how Wales has developed its community eye care services. Since the devolution of healthcare to Wales on 1 July 1999 [1], significant changes...

Providing primary eyecare services during a global pandemic: the new normal

It would be fair to say that 2020 hasn’t quite turned out to be the year that anyone predicted. Living with a global pandemic has become our reality and we are having to get used to many aspects of our...

The Preston Rule

The selection, specification and fitting of a spectacle frame necessitates the recording of certain measurements particular to the frame. These measurements are also essential when it is required to manufacture a handmade spectacle frame. Instruments designed to accomplish this task...

Vitreomacular traction and full thickness macular hole

Clinical scenario: A 64-year-old lady presented to the clinic with a few weeks history of sudden onset of metamorphopsia, central blur and reduced vision in her right eye. The ocular examination and ocular coherence tomography confirmed right eye focal vitreomacular...

Strabismus in thyroid eye disease

Pathogenesis Thyroid eye disease (TED) is an auto-immune condition, in the initial phase there is lymphocytic infiltration and oedema of the extraocular muscles with deposition of glycosaminoglycans and hyaluronic acid and adipogenesis, which can lead to an increase in the...

The management of chronic central serous chorioretinopathy

Central serous chorioretinopathy (CSCR) is a common retinal disease characterised by one or more serous neurosensory detachments. Patients present with acute onset blurring of vision, metamorphopsia and / or central scotomas. The condition is six times more common in men...

Ultrasound biomicroscopy (part 2): primary angle closure

Patients with primary angle closure or primary angle closure glaucoma [PAC(G)] comprise a significant subgroup affecting around 10% of glaucoma patients amongst Caucasians. Assessment of the patient with angle closure, or narrow angles, requires gonioscopy. However, whilst identifying the presence...

The management of antiplatelets and anticoagulation in elective ophthalmic surgery

Clinical scenario: A 57-year-old gentleman who is scheduled to have Mohs micrographic surgery and reconstruction for a medial canthal basel cell carcinoma (BCC) has been started on aspirin and clopidogrel following a coronary stent three weeks ago. Does the antiplatelet...

The management of possibly progressive pterygium

A 43-year-old Sudanese male patient is referred by his GP with a fleshy lesion encroaching the nasal cornea for the last six months. History Make note of: risk factors, i.e. UV exposure and ocular irritation - history of living in...

Discussing treatment modalities for bilateral wet AMD

A 65-year-old lady with bilateral wet AMD and vision of 6/24 comes with an internet search about current therapies. How do you explain the various treatment modalities available? There are two NICE approved treatments for wet age-related macular degeneration (AMD)....

Ocular electrophysiology

A 34-year-old woman, who is a CEO in a multinational firm, has been losing vision over the last 12 months. She has seen her opticians, who initially tried different glasses but could not improve things. Clinical examination is unremarkable. How...